The Lancet puts spotlight on unsafe abortion and other urgent reproductive-health issues

As many as half of all women who experience an unsafe abortion become hospitalized due to complications, such as severe bleeding or infection.

Photo courtesy of the David and Lucile Packard Foundation.

This month the British medical journal The Lancet concluded its landmark series on sexual and reproductive health, which featured an article exploring the causes and grave consequences of unsafe abortion. The article notes that worldwide, approximately eight women die every hour because of complications of unsafe abortion. The authors conclude that “ending the silent pandemic of unsafe abortion is an urgent public-health and human-rights imperative.”

Titled “Unsafe abortion: The preventable pandemic,” the article is authored by David A. Grimes, MD, of the University of North Carolina Medical School; Janie Benson, DrPH, and Bela Ganatra, MD, both of Ipas; and other noted experts in obstetrics-gynecology or international public health. It is featured in a special series of articles on sexual and reproductive health published over the past several months.

Commenting on the pandemic, Dr. Janie Benson, Vice President for Research and Evaluation at Ipas, stated, “As with other serious threats to public health, whether in the developing world or elsewhere, the problem of unsafe abortion should be approached by using evidence-based solutions.” She went on to note that “after decades of public-health research on the subject, the clear and incontrovertible evidence shows that when abortion is made legal, safe and easily accessible, women’s health rapidly improves.” Lancet Editor Dr. Richard Horton, writing in a comment introducing the special series, asserts that both the journal and the World Health Organization, which provided support for the special series, back this conclusion.

The article reviews evidence from numerous countries demonstrating that legally restricting abortion does not reduce the overall number of abortions, but does, often dramatically, increase the rates of maternal death and injury from unsafe abortion. Conversely, areas in which abortion and contraception services are widely accessible have among the very lowest overall abortion rates in the world.

By definition, unsafe abortions are those “done by individuals without the requisite skills, or in an environment below medical standards.” Approximately 19-20 million such abortions occur annually, almost all in developing countries.

Approximately a quarter of the world’s population lives in countries in which abortion is legally permitted under no or nearly no circumstances. And, consequently, the silent, preventable pandemic of unsafe abortion persists. The authors thus conclude that the root causes of maternal deaths and injuries from unsafe abortion are “apathy and disdain toward women.”

Bibliography

Grimes, David A., Janie Benson, Susheela Singh, Mariana Romero, Bela Ganatra, Friday E. Okonofua, Iqbal H. Shah. 2006. Unsafe abortion: The preventable pandemic. Lancet. 2006, 368(9550):1908-1919.

Horton, Richard. 2006. Reviving reproductive health. Lancet. 2006, 368(9547):1549.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258